Association of Lipoprotein(a) With Recurrent Ischemic Events Following Percutaneous Coronary Intervention
| Autor: | Seong-Wook Park, Seung-Jung Park, Do-Yoon Kang, Yong-Hoon Yoon, Pil Hyung Lee, Soo-Jin Kang, Ki Hoon Han, Seung-Whan Lee, Jung-Min Ahn, Cheol Whan Lee, Young-Hak Kim, Duk-Woo Park |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Coronary Artery Disease Revascularization Percutaneous Coronary Intervention Risk Factors Internal medicine medicine Humans Prospective Studies Myocardial infarction Risk factor biology business.industry Hazard ratio Percutaneous coronary intervention Lipoprotein(a) medicine.disease Treatment Outcome Conventional PCI biology.protein Cardiology Population study Cardiology and Cardiovascular Medicine business Biomarkers |
| Zdroj: | JACC: Cardiovascular Interventions. 14:2059-2068 |
| ISSN: | 1936-8798 |
| DOI: | 10.1016/j.jcin.2021.07.042 |
| Popis: | Objectives This study evaluated the association between elevated levels of lipoprotein(a) [Lp(a)] and risk of recurrent ischemic events in patients who underwent percutaneous coronary intervention (PCI). Background Elevated levels of Lp(a) have been identified as an independent, possibly causal, risk factor for atherosclerotic cardiovascular disease in a general population study. Methods A prospective single-center registry was used to identify 12,064 patients with baseline Lp(a) measurements who underwent PCI between 2003 and 2013. The primary outcomes were a composite of cardiovascular death, spontaneous myocardial infarction, and ischemic stroke. Results From the registry, 3,747 (31.1%) patients had high Lp(a) (>30 mg/dL) and 8,317 (68.9%) patients had low Lp(a) (≤30 mg/dL). During a median follow-up of 7.4 years, primary outcomes occurred in 1,490 patients, and the incidence rates of primary outcomes were 2.0 per 100 person-years in the high-Lp(a) group and 1.6 per 100 person-years in the low-Lp(a) group (adjusted hazard ratio [aHR]: 1.17; 95% confidence interval [CI]: 1.05-1.30; P = 0.004). Increased risk of recurrent ischemic cardiovascular events in the high-Lp(a) group was consistent in various subgroups including patients receiving statin treatment at discharge (aHR: 1.18; 95% CI: 1.03-1.34; P = 0.011). In addition, the risk of repeated revascularization was significantly higher in the high-Lp(a) group (aHR: 1.13; 95% CI: 1.02-1.25; P = 0.022). Conclusions Elevated levels of Lp(a) were significantly associated with the recurrent ischemic events in patients who underwent PCI. This study provides a rationale for outcome trials to test Lp(a)-lowering therapy for secondary prevention in patients undergoing PCI. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|